Kelsi Nicole Chisom, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5022630 Issued in NC

Practice address

9930 Kincey Ave Ste 200
Huntersville, NC 28078-6541

Phone

(704) 887-4530

NPI assigned

Feb 12, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 7

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Georgetown Physician Associates, LLCGroup PAC ID 2365697398, 221 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098
• Tidelands Georgetown Memorial Hospital Hospital, Georgetown, SC, CCN 420020
• Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kchisom1737378@direct.novanthealth.org
• Direct secure messaging: kchisom466894@direct.musc.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Georgetown Physician Associates, LLC

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1235475930
  Medicare reassignment Care Compare group NPD
• The Presbyterian Hospital

  • Geriatric Medicine (Internal Medicine) Physician
  • Charlotte, NC
  • NPI 1053365817
  Medicare reassignment Care Compare group
• Novant Health Medical Group, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1306950282
  Medicare reassignment
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Cardiovascular Disease Physician
  • Charlotte, NC
  • NPI 1720590185
  NPD
• Novant Health Medical Group, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1891764320
  NPD
• The Presbyterian Hospital

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1740169820
  NPD
• The Presbyterian Hospital

  • Cardiovascular Disease Physician
  • Charlotte, NC
  • NPI 1811610058
  NPD
• Georgetown Physician Associates LLC

  • Family Medicine Physician
  • Georgetown, SC
  • NPI 1881410587
  NPD
• Georgetown Physician Associates, LLC

  • Cardiovascular Disease Physician
  • Pawleys Island, SC
  • NPI 1548715279
  NPD
• Novant Medical Group, Inc.

  • Interventional Cardiology Physician
  • Charlotte, NC
  • NPI 1205836434

  Cardiovascular Disease

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Presbyterian Hospital

  • General Acute Care Hospital
  • Huntersville, NC
  • NPI 1346291309
  Care Compare affiliation
• Georgetown Memorial Hospital

  • Skilled Nursing Facility
  • Georgetown, SC
  • NPI 1881307056

  Hospital

  Care Compare affiliation
• Georgetown Memorial Hospital

  • General Acute Care Hospital
  • Georgetown, SC
  • NPI 1982604021
  Care Compare affiliation
• Waccamaw Community Hospital

  • General Acute Care Hospital
  • Murrells Inlet, SC
  • NPI 1972503910
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1598529448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "844-266-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 KINCEY AVE STE 200",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786541",
            "telephone_number": "704-887-4530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "456 N Main St",
            "address_purpose": "LOCATION",
            "city": "Hemingway",
            "state": "SC",
            "postal_code": "295549190",
            "country_code": "US",
            "telephone_number": "843-558-9319",
            "fax_number": "843-558-9818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln Ste 303A",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-848-5310",
            "fax_number": "843-237-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 S Morgan Ave",
            "address_purpose": "LOCATION",
            "city": "Andrews",
            "state": "SC",
            "postal_code": "295102959",
            "country_code": "US",
            "telephone_number": "843-264-5253",
            "fax_number": "843-264-5970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4040 Highway 17 Unit 202",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765098",
            "country_code": "US",
            "telephone_number": "843-235-3131",
            "fax_number": "843-237-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4040 Highway 17 Unit 202",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765098",
            "country_code": "US",
            "telephone_number": "843-235-3131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9653 Ocean Hwy",
            "address_purpose": "LOCATION",
            "city": "Pawleys Island",
            "state": "SC",
            "postal_code": "295857425",
            "country_code": "US",
            "telephone_number": "843-235-3131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Crow Ln",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771663",
            "country_code": "US",
            "telephone_number": "843-235-3131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4070 Highway 17",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765033",
            "country_code": "US",
            "telephone_number": "843-235-3131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9653 Ocean Hwy",
            "address_purpose": "LOCATION",
            "city": "Pawleys Island",
            "state": "SC",
            "postal_code": "295857425",
            "country_code": "US",
            "telephone_number": "843-235-3131",
            "fax_number": "843-237-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1014 Huger DR",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403322",
            "country_code": "US",
            "telephone_number": "843-235-3131",
            "fax_number": "843-237-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHISOM",
        "first_name": "KELSI",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "28364",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5022630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kchisom466894@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "701 S Morgan Ave",
            "city": "Andrews",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295102959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kchisom466894@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4040 Highway 17 Unit 202",
            "city": "Murrells Inlet",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295765098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kchisom466894@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "address_1": "4040 Highway 17 Unit 202",
            "city": "Murrells Inlet",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295765098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kchisom466894@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "456 N Main St",
            "city": "Hemingway",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295549190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kchisom466894@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1014 Huger DR",
            "city": "Georgetown",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294403322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kchisom466894@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9653 Ocean Hwy",
            "city": "Pawleys Island",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295857425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kchisom466894@direct.musc.edu",
            "affiliation": "Y",
            "affiliationName": "Georgetown Physician Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2200 Crow Ln Ste 303A",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295771663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Annie Chhay, PHARMD
• Jewel Chickering
• Carey Price Childers, DPT
• Paulina Chin, L.C.S.W.
• Tiffany Chirokas, LCSWA
• Kasey Ellis Chmelik, FNP
• Choice Diabetic Supply, Inc.
• Daniela Chouloute
• Khouri Rene' Christian, DNP
• Christine E Lemley OD PLLC

• Nurse Practitioner in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.